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The absence of a relation between the periconceptional use of vitamins and neural-tube defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group.
N Engl J Med. 1989 Aug 17; 321(7):430-5.NEJM

Abstract

Whether taking multivitamins or folate around the time of conception can reduce a woman's risk of having a child with a neural-tube defect is controversial. To investigate this question, we examined the periconceptional use of vitamin supplements by women who had a conceptus with a neural-tube defect (n = 571), women who had had a stillbirth or a conceptus with another malformation (n = 546), and women who had had a normal conceptus (n = 573). Women with conceptuses with neural-tube defects were identified either prenatally or postnatally and were matched to control mothers for gestational age. To minimize recall bias, we interviewed nearly all the women within five months of the diagnosis of a birth defect or the birth of the infant (mean, 84 days); information on vitamin use was obtained by an interviewer who was unaware of the outcome of pregnancy. The rate of periconceptional multivitamin use among the mothers of infants with neural-tube defects (15.8 percent) was not significantly different from the rate among mothers in either the abnormal or the normal control group (14.1 percent and 15.9 percent, respectively). After adjustment for potential confounding factors, the odds ratio for having an infant with a neural-tube defect among women classified as having had full supplementation with multivitamins was 0.95 as compared with the mothers of the abnormal infants (95 percent confidence interval, 0.78 to 1.14) and 1.00 as compared with the mothers of normal infants (95 percent confidence interval, 0.83 to 1.20). There were no differences among the groups in the use of folate supplements. The adjusted odds ratio for having an infant with a neural-tube defect among those receiving the recommended daily allowance of folate was 0.97 as compared with the mothers of abnormal infants (95 percent confidence interval, 0.79 to 1.18) and 0.98 as compared with the mothers of normal infants (95 percent confidence interval, 0.80 to 1.20). We conclude that the periconceptional use of multivitamins or folate-containing supplements by American women does not decrease the risk of having an infant with a neural-tube defect.

Authors+Show Affiliations

National Institute of Child Health and Human Development, Bethesda, MD 20892.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

2761577

Citation

Mills, J L., et al. "The Absence of a Relation Between the Periconceptional Use of Vitamins and Neural-tube Defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group." The New England Journal of Medicine, vol. 321, no. 7, 1989, pp. 430-5.
Mills JL, Rhoads GG, Simpson JL, et al. The absence of a relation between the periconceptional use of vitamins and neural-tube defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group. N Engl J Med. 1989;321(7):430-5.
Mills, J. L., Rhoads, G. G., Simpson, J. L., Cunningham, G. C., Conley, M. R., Lassman, M. R., Walden, M. E., Depp, O. R., & Hoffman, H. J. (1989). The absence of a relation between the periconceptional use of vitamins and neural-tube defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group. The New England Journal of Medicine, 321(7), 430-5.
Mills JL, et al. The Absence of a Relation Between the Periconceptional Use of Vitamins and Neural-tube Defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group. N Engl J Med. 1989 Aug 17;321(7):430-5. PubMed PMID: 2761577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The absence of a relation between the periconceptional use of vitamins and neural-tube defects. National Institute of Child Health and Human Development Neural Tube Defects Study Group. AU - Mills,J L, AU - Rhoads,G G, AU - Simpson,J L, AU - Cunningham,G C, AU - Conley,M R, AU - Lassman,M R, AU - Walden,M E, AU - Depp,O R, AU - Hoffman,H J, PY - 1989/8/17/pubmed PY - 1989/8/17/medline PY - 1989/8/17/entrez SP - 430 EP - 5 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 321 IS - 7 N2 - Whether taking multivitamins or folate around the time of conception can reduce a woman's risk of having a child with a neural-tube defect is controversial. To investigate this question, we examined the periconceptional use of vitamin supplements by women who had a conceptus with a neural-tube defect (n = 571), women who had had a stillbirth or a conceptus with another malformation (n = 546), and women who had had a normal conceptus (n = 573). Women with conceptuses with neural-tube defects were identified either prenatally or postnatally and were matched to control mothers for gestational age. To minimize recall bias, we interviewed nearly all the women within five months of the diagnosis of a birth defect or the birth of the infant (mean, 84 days); information on vitamin use was obtained by an interviewer who was unaware of the outcome of pregnancy. The rate of periconceptional multivitamin use among the mothers of infants with neural-tube defects (15.8 percent) was not significantly different from the rate among mothers in either the abnormal or the normal control group (14.1 percent and 15.9 percent, respectively). After adjustment for potential confounding factors, the odds ratio for having an infant with a neural-tube defect among women classified as having had full supplementation with multivitamins was 0.95 as compared with the mothers of the abnormal infants (95 percent confidence interval, 0.78 to 1.14) and 1.00 as compared with the mothers of normal infants (95 percent confidence interval, 0.83 to 1.20). There were no differences among the groups in the use of folate supplements. The adjusted odds ratio for having an infant with a neural-tube defect among those receiving the recommended daily allowance of folate was 0.97 as compared with the mothers of abnormal infants (95 percent confidence interval, 0.79 to 1.18) and 0.98 as compared with the mothers of normal infants (95 percent confidence interval, 0.80 to 1.20). We conclude that the periconceptional use of multivitamins or folate-containing supplements by American women does not decrease the risk of having an infant with a neural-tube defect. SN - 0028-4793 UR - https://www.unboundmedicine.com/medline/citation/2761577/The_absence_of_a_relation_between_the_periconceptional_use_of_vitamins_and_neural_tube_defects__National_Institute_of_Child_Health_and_Human_Development_Neural_Tube_Defects_Study_Group_ L2 - http://www.nejm.org/doi/full/10.1056/NEJM198908173210704?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -